Factors and Strategies Influencing Chemotherapy Safety Among Oncology Nurses: A Qualitative Descriptive Study

The purpose of this research is to describe the factors affecting hazardous chemotherapy exposure and strategies to foster chemotherapy safety among oncology nurses. Fifteen oncology nurses and 5 oncology nurse managers were recruited from 2 medical centers in the Midwest United States through convenience purposive sampling. A qualitative descriptive approach was employed. Semi-structured interviews were conducted with the participants and analyzed using the content analysis method. Five main themes emerged: (1) description of chemotherapy exposure incidents, (2) nurse's personal health beliefs, (3) cues to adhere to chemotherapy handling guidelines, (4) invisible exposure to chemotherapy, and (5) strategies to promote chemotherapy safety at the workplace. Important strategies that promote chemotherapy safety for nurses are providing continuous education on chemotherapy safety, offering chemotherapy-specific equipment and personal protective equipment in several sizes, promoting nurses' health beliefs toward chemotherapy safety (perceived susceptibility, perceived severity, perceived benefits, perceived barriers, and perceived self-efficacy), supporting a culture of safety at the workplace, having policies on handling guidelines and exposure incident reporting, monitoring nurses' adherence to chemotherapy handling guidelines, using hazard labels and alerts, and monitoring chemotherapy contamination on common surfaces in oncology settings. Oncology nurses and nurse managers should be involved in designing strategies that promote nurses' occupational safety.